tbuckley/cabot-search huggingface dataset:
OC-080 Excess Steroid Use in IBD: Too Much, How Much and Why? Results From A Nationwide Audit
Authors: T Raine, A Bassi, E Fogden, B Hayee, JK Limdi, H Ludlow, S McLaughlin, GC Parkes, P Patel, MA Smith, C Selinger
Journal: Gut (2016)

<h3>Introduction</h3> Corticosteroids are the cornerstone of inducing remission in IBD but are limited in their ability to maintain remission, and associated with significant side effects. This is the first nationwide outpatient study of steroid use in IBD and factors affecting their use. <h3>Methods</h3> We audited consecutive IBD patients attending clinics at 11 centres over 3 months using a web-based assessment tool. Cases meeting criteria for steroid excess (SE) as defined by ECCO guidelines were blind peer reviewed and classified as non-IBD use, unavoidable and inappropriate steroid excess (ISE). Associations between steroid use and patient and institutional factors were analysed. <h3>Results</h3> Of 1177 patients [48% CD, 49% UC, 3% IBD-U] 79% were in remission/mild disease, 18.5% had moderate and 2.5% severe disease. In the previous 12 months, 30% had received steroids, 13.8% had SE. Peer review revealed that SE was inappropriate in 51.2% of these (8% non-IBD use; 40.7% unavoidable). Excess steroid exposure was more common in patients with active UC compared to active CD (41.6% vs 26.6%; <i>p</i> = 0.02). In multivariate analysis, disease activity was a significant predictor of SE/ISE. In addition, being established on anti-TNF agents protected against SE and ISE in CD. Exposure to thiopurine (SE + ISE) and starting anti-TNF therapy (ISE) were associated with excess steroid use in UC. CD patients from centres with an IBD MDT were less likely to have SE, similarly CD patients in centres with combined surgical clinics were less likely to experience SE and ISE. Care in centres with dedicated IBD clinics was associated with less SE and ISE in patients with UC. Centres with large numbers of GI trainees showed higher rates of SE in UC and SE and ISE in CD. (All of above independent predictors on multi-variate with significance p &lt; 0.001) <h3>Conclusion</h3> We identified inappropriate excess steroid use in 7% of UK IBD patients. Risk factors for steroid exposure differed between UC and CD, likely reflecting <i>inter alia</i>, differences in access to biologic drugs. Our study is the first to demonstrate positive effects of service configurations (IBD MDT, dedicated IBD clinics, combined surgical clinics) on treatment outcomes even after correction for differences in disease severity. There was an association between ISE in Crohn’s and the number of GI trainees per centre suggesting possible gaps in training. Routine recording of excess steroid exposure is feasible and should be considered as a quality marker for outcomes of IBD services. <h3>Disclosure of Interest</h3> None Declared
Large-volume paracentesis and intravenous saline: Effects on the renin-angiotensin system
Authors: J Cabrera
Journal: Hepatology (1991)

Fourteen cirrhotic patients with tense ascites were treated with total paracentesis and intravenous isotonic saline infusion. Standard liver and kidney function tests, plasma renin activity and aldosterone concentration were measured before, at 48 hrs and at 7 days after total paracentesis. The volume of ascites removed was 7.7 ± 5.6 1 (mean ± S.E.M.). None of the treated patients had clinical complications or significant alterations in liver or kidney function test results. Paracentesis and intravenous isotonic saline infusion were not associated with significant changes in mean plasma renin activity or plasma aldosterone concentration. These results suggest that this therapeutic procedure could be a safe and cost-effective alternative treatment of tense ascites in patients with cirrhosis. (HEPATOLOGY 1991;14:1025–1028.)
Incidence and risk factors for gout in white men
Authors: R. Roubenoff
Journal: JAMA (1991)

<h3>Objective.</h3> —To identify potentially modifiable risk factors for the development of gout. <h3>Design.</h3> —Longitudinal cohort study (The Johns Hopkins Precursors Study). <h3>Participants.</h3> —Of 1337 eligible medical students, 1271 (95%) received a standardized medical examination and questionnaire during medical school. The participants were predominantly male (91%), white (97%), and young (median age, 22 years) at cohort entry. <h3>Outcome Measure.</h3> —The development of gout. <h3>Results.</h3> —Sixty cases of gout (47 primary and 13 secondary) were identified among 1216 men; none occurred among 121 women (<i>P</i>=.01). The cumulative incidence of all gout was 8.6% among men (95% confidence interval, 5.9% to 11.3%). Body mass index at age 35 years (<i>P</i>=.01), excessive weight gain (&gt;1.88 kg/m<sup>2</sup>) between cohort entry and age 35 years (<i>P</i>=.007), and development of hypertension (<i>P</i>=.004) were significant risk factors for all gout in univariate analysis. Multivariate Cox proportional hazards models confirmed the association of body mass index at age 35 years (relative risk [RR] = 1.12;<i>P</i>=.02), excessive weight gain (RR = 2.07;<i>P</i>=.02), and hypertension (RR = 3.26;<i>P</i>=.002) as risk factors for all gout. Hypertension, however, was not a significant risk factor for primary gout. <h3>Conclusions.</h3> —Obesity, excessive weight gain in young adulthood, and hypertension are risk factors for the development of gout. Prevention of obesity and hypertension may decrease the incidence of and morbidity from gout; studies of weight reduction in the primary and secondary prevention of gout are indicated. (<i>JAMA</i>. 1991;266:3004-3007)
More names for depression: is a rose a rose?
Authors: R. D. Reynolds
Journal: JAMA (1997)

<h3>To the Editor.</h3> —In his recent letter regarding the undertreatment of depression, Dr Berger<sup>1</sup>identifies the major problem that primary care physicians face when dealing with depressive illness—getting the patient to accept the diagnosis. He suggests that we need a new name for the illness that does not carry the pejorative connotations of the term depression. For the last 6 years, I have taken a novel approach to somatic presentations of depressive illness. When faced with complaints such as chronic headaches, fatigue, sleep disturbance, or the ubiquitous request for "something for my nerves," I ask about core limbic symptoms since depression affects all the limbic system structures and functions.<sup>2-4</sup>These symptoms include poor quality of sleep, fatigue, irritability, exaggerated pain perception, difficulty concentrating, trouble with short-term memory, difficulty with appetite control, anhedonia, decreased sexual interest, excessive guilt, and suicidal thoughts (often initially expressed as an urge to run
Prognosis
Authors: Norman A. Welch
Journal: JAMA (1964)

ONE OF THE determining factors in any prognosis is the ability and dedication of the attending physicians. From that standpoint, we are fortunate, because this case has been studied by experts. Some of the finest clinicians and a top pathologist have been in consultation. If we can't turn out a promising prognosis on that basis, the patient simply isn't trying. It is as vital in this "case" as in a real one that the patient does try. No amount of therapy will help unless he tries. If he doesn't, the disappointing results will not be limited to town and gown. They will be inflicted on the public we are sworn to serve. No physician can, in good conscience, afford to be indifferent to this problem. All aspects of it cannot be solved quickly. The town-gown syndrome is one we have had always with us. It will take time and understanding
Effect of pectasol-c modified citrus pectin (P-MCP) treatment (tx) on PSA dynamics in non- metastatic biochemically relapsed prostate cancer (BRPC) patients (pts): Primary outcome analysis of a prospective phase II study.
Authors: Daniel Keizman, Moshe A. Frenkel, Avivit Peer, Eli Rosenbaum, David Margel, David Sarid, Victoria Neiman, Ilan Leibovitch, Itay Aharon Sternberg, Ben Boursi, Maya Gottfried, Hadas Dresler, Isaac Eliaz
Journal: Journal of Clinical Oncology (2019)

e16609 Background: 30% of pts with localized PC will have a biochemical relapse post local tx. Their optimal tx remains elusive. While androgen deprivation therapy is effective in reducing PSA level, its long-term benefit remain undefined, and it is associated with significant toxicities. Thus, evaluation of new non-toxic compounds in this pt population is warranted. P-MCP is a competitive inhibitor of galectin-3, a carbohydrate-binding protein, known to be involved in cancer pathogenesis. Pre-clinical data suggest that P-MCP is active in PC, and in two previous smaller clinical trials in biochemically relapsed prostate cancer (BRPC) pts, a PSA response/stabilization rate of 57%-75% was noted. In the present study, we aimed to evaluate the safety and PSA dynamics of P-MCP tx in BRPC pts. Methods: non-castrate non-metastatic BRPC pts were enrolled in a prospective phase 2 study of oral P-MCP tx, at 4.8 grams X 3/day for 6 months (mos). Eligible pts had 3 consecutive rise of PSA, without any tx in the previous 3 mos, a normal level of serum testosterone, and negative scans. The primary outcome was the rate of pts without disease progression (DP) (clinically, biochemically with stabilization/decrease of PSA or improvement of PSA doubling time = PSADT, and radiologically) at 6 mos. A Sample size of ≥ 50 pts provided 85% power to assess a decrease in DP rate from 80% (natural history) to 40% (P-MCP tx) at 6 mos. Pts that did not progress at 6 mos, were treated for subsequent 12 mos (secondary outcome of long term effect). Herein we report the results of the primary outcome analysis. Results: 53 pts were enrolled. Median age was 74 years. Tx of the primary tumor consisted of surgery in 13% (n = 7), radiation in 60% (n = 32), and both in 26% (n = 14). No pt had tx related grade 3/4 toxicity. One pt withdrew his consent after 1 mos. At present, 46 pts completed 6 mos of tx, and were analyzed for the primary outcome. Among them, 20% (n = 9) had grade 1 toxicity (all gas and bloating ). The primary outcome was met in 76% (n = 35), that did not progress at 6 mos of tx. Of these, 59% (n = 27) had a stabilization/decrease of PSA, 70% (n = 32) had an improvement (increase) of PSADT, and all had no metastases on scans at 6 mos. DP at 6 mos was noted in 24% (n = 11: PSA only in 20%, n = 9; PSA and scans in 4%, n = 2). Full cohort data (additional 6 pts that will complete 6 mos of tx) will be available by June 2019. Conclusions: The present study suggests the safety and potential benefit of P-MCP tx on progression of BRPC. Clinical trial information: NCT01681823.
Diphenylhydantoin Toxicity
Authors: Richard H. Helfant
Journal: JAMA (1967)

<h3>To the Editor:—</h3> Two articles "Fatalities Following Intravenous Use of Sodium Diphenylhydantoin for Cardiac Arrhythmias" and "Fatal Ventricular Fibrillation Following Intravenous Sodium Diphenylhydantoin Therapy" (<b>200</b>:335-338, 1967) incriminate diphenylhydantoin sodium as the causative factor in the death of three patients. The three patients reported in the two articles were all rapidly deteriorating clinically despite intensive medical treatment at the time of diphenylhydantoin administration. In this setting, the incrimination of diphenylhydantoin as<i>the</i>causative factor in the death of at least two of these patients is questionable. In the initial report both patients had pulmonary edema, one with falling blood pressure. The third patient was semiconscious with sepsis and hypoxia. It would have been important to indicate the blood pressure during and after the diphenylhydantoin infusion since this is an important determinant of the rate of the drug's administration. In contrast to these three cases, a substantial clinical experience has been
Calcium Measurements with Electron Probe X-Ray and Electron Energy Loss Analysis
Authors: Ann LeFurgey, Peter Ingram
Journal: Environmental Health Perspectives (1990)

This paper presents a broad survey of the rationale for electron probe X-ray microanalysis (EPXMA) and the various methods for obtaining qualitative and quantitative information on the distribution and amount of elements, particularly calcium, in cryopreserved cells and tissues. Essential in an introductory consideration of microanalysis in biological cryosections is the physical basis for the instrumentation, fundamentals of X-ray spectrometry, and various analytical modes such as static probing and X-ray imaging. Some common artifacts are beam damage and contamination. Inherent pitfalls of energy dispersive X-ray systems include Si escape peaks, doublets, background, and detector calibration shifts. Quantitative calcium analysis of thin cryosections is carried out in real time using a multiple least squares fitting program on filtered X-ray spectra and normalizing the calcium peak to a portion of the continuum. Recent work includes the development of an X-ray imaging system where quantitative data can be retrieved off-line. The minimum detectable concentration of calcium in biological cryosections is approximately 300 mumole kg dry weight with a spatial resolution of approximately 100 A. The application of electron energy loss (EELS) techniques to the detection of calcium offers the potential for greater sensitivity and spatial resolution in measurement and imaging. Determination of mass thickness with EELS can facilitate accurate calculation of wet weight concentrations from frozen hydrated and freeze-dried specimens. Calcium has multiple effects on cell metabolism, membrane transport and permeability and, thus, on overall cell physiology or pathophysiology. Cells can be rapidly frozen for EPXMA during basal or altered functional conditions to delineate the location and amount of calcium within cells and the changes in location and concentration of cations or anions accompanying calcium redistribution. Recent experiments in our laboratory document that EPXMA in combination with other biochemical and electrophysiological techniques can be used to study, for example, sodium and calcium compartmentation in cultured cardiac cells. Such analyses can also be used to clarify the role of calcium in anoxic renal cell injury and to evaluate proposed ionic defects in cells of individuals with cystic fibrosis.
Longitudinal Investigation of Dietary Exposure to Selected Pesticides
Authors: David L. MacIntosh, Caroline W. Kabiru, P. Barry Ryan
Journal: Environmental Health Perspectives (2001)

Between September 1995 and September 1996, 4-day composite duplicate plate samples (379 solid food samples and 303 beverage samples) were obtained from a stratified random sample of 75 individuals in Maryland and analyzed for the presence of 10 pesticides. Samples were collected in each of six approximately equally spaced cycles as part of a larger pilot investigation of longitudinal exposure to pesticides and other elements. Chlorpyrifos was detected in 38.3% of the solid food samples, malathion in 75.2%, and p,p'-DDE in 21.4%. Other pesticides were detected in less than 10% of the solid food samples. Pesticide residues were not detected in duplicate beverage samples. In solid food samples, the mean concentration of chlorpyrifos was 0.7 (SD 1.7) microg/kg, 1.8 (2.1) for malathion, and 0.2 (0.6) for p,p'-DDE. The detection rate and mean concentration of chlorpyrifos, malathion, and p,p'-DDE varied by a factor of 2-3 among sampling cycles and significantly according to results from several statistical analyses. Co-occurrence of chlorpyrifos and malathion in solid food samples was found relatively frequently and also varied with time. Pesticides were detected in food samples with greatest frequency in spring and summer months and with lowest frequency in winter months. These results support the hypothesis that 4-day average exposure to chlorpyrifos and malathion varies over time for this population mean and for individual members of the population and that correlation between exposures to these two organophosphate pesticides can occur. The measurements of pesticide levels in duplicate plate samples presented here can be used to evaluate and set parameters for dietary exposure models.
NIH intramural program endangered
Authors: L. D. Grouse
Journal: JAMA (1980)

The program of intramural research at the National Institutes of Health (NIH) could be seriously damaged by 1982 unless the sprawling Bethesda, Md, facility can curtail its expenditures. Dr Robert Goldberger, NIH Deputy Director for Science, estimates that with President Carter's 1981 budget increase of less than 4% for the Bethesda-based institutes (which will result in an approximate 10% drop in overall buying power), such obligated costs as salaries will commit a dangerously high proportion of the intramural budget and lead to severe financial pressures on the NIH mission. It appears that extramural funding for 1981 will stress support for investigator-initiated research grants, allowing approximately an 11% increase in this area, with the boost for intramural research lagging far behind. What consequences will the contraction of intramural NIH's scientific mission have on US medical practice and medical education? Consider the large number of well-trained researchers and clinicians who served their
THE PURIFICATION OF SEWAGE BY BACTERIOLOGIC METHODS.
Journal: JAMA (1898)

The London County Council has lately undertaken a study of sewage and its purification by bacteriologic methods. Experiments on the changes in crude London sewage by its filtration through coke are to be conducted at the outfall at Crossness. Pending the construction of the filter and the completion of other arrangements, Dr. A. C.Houston, the bacteriologist who has been assigned by the Council to co-operate in these investigations, has made a careful bacteriologic study of the raw sewage, preparatory to the special inquiry into the changes brought about by the micro-organisms in the filterbeds which are designed for its purification. The results of Dr.Houston'swork have been published by the Council as the first of a series of reports on the "Filtration of Sewage." The work was done in the Public Health Laboratory of St. Bartholomew's Hospital; and thanks are accorded to Dr.Klein"for advice and help
Cell-free DNA Analysis for Noninvasive Examination of Trisomy
Authors: Mary E Norton, Ronald J Wapner
Journal: New England Journal of Medicine (2015)

ConclusionsIn this large, routine prenatal-screening population, cfDNA testing for trisomy 21 had higher sensitivity, a lower false positive rate, and higher positive predictive value than did standard screening with the measurement of nuchal translucency and biochemical analytes.(Funded by Ariosa Diagnostics and Perinatal Quality Foundation; NEXT ClinicalTrials.govnumber, NCT01511458.)
Dr. Colwell's Daily Log for Physicians, 1929.
Journal: JAMA (1929)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Humane Medicine
Authors: T. N. RENGEL
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 April 1973Humane MedicineT. N. RENGEL, M.D.T. N. RENGEL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-4-616_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Our medical literature has been wanting material like that presented by Dr. Clouser ("'The Sanctity of life': An Analysis of a Concept."Ann Intern Med78:119-125, 1973). Being so deeply immersed in the "institutionalized dehumanization" of patients ("Distance Between the Doctor and the Patient."Ann Intern Med78:64, 1973), we find it difficult to maintain an appreciation of those ideas that are most basic and, indeed, give cause and reason to the establishment and continuation of the practice of medicine. Unfortunately, many of us are losing the "seasoning" and some of the fervor with which we entered... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1973Volume 78, Issue 4Page: 616-616 Issue Published: 1 April 1973 PDF downloadLoading ...
Gynecological Malignant Disease in the Eastern Region of Scotland: II. Malignant Disease of Ovary
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
<i>QuickStats:</i>Percentage* of Adults Aged 18–64 Years Who Had Visited or Talked to a Health Care Professional in the Past 12 Months,† by Race/Ethnicity§ — National Health Interview Survey, 2010 and 2015¶
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

From 2010 to 2015, there was an increase in the percentage of non-Hispanic white adults (82.5% to 84.0%) and non-Hispanic black adults (80.5% to 83.5%) aged 18-64 years who had seen or talked to a health care professional in the past 12 months. In 2010, non-Hispanic white adults aged 18-64 years were the most likely to have seen or talked to a health professional in the past 12 months, but there was no significant difference between non-Hispanic white and non-Hispanic black adults in 2015. In both 2010 and 2015, Hispanic adults aged 18-64 years were the least likely to have seen or talked to a health care professional in the past 12 months.